Over 122 million people are at risk of NTDs in Nigeria and the country is endemic for all 5 PC-NTDs. Cutaneous manifestations of Onchocerciasis are caused by skin reactions to dead/dying microfilariae leading to severe dermatitis. Lymphatic Filariasis is caused by filarial worms and patients often present with chronic manifestations such as lymphoedema, hydrocoele, and elephantiasis. PC-NTDs. The state boasts of a functional state and community- level coordinated response for NTD control under the state ministry of health. Of the five PC- NTDs, Onchocerciasis and LF are peculiar because they often manifest with chronic debilitating skin lesions and associated disfigurement at the high risk of permanent physical impairments and disabilities.

The project aims at bridging the health and development information gap among illiterate women and girls in Southeast Nigeria through the use of smart phones to access audio messages. Its implementation comprises of two stages: at the pilot stage, the easiest and cost effective medium to access these audio messages would be identified using selected intervention groups (400 women and girls) while the scale up stage will target a wider reach (southeast Nigeria) using the outcome of the pilot stage.

The TB LON regions 1 & 2 Project focuses on locally generated solutions to provide TB prevention, screening, diagnosis, treatment and notification, while addressing stigma and discrimination. The TB LON region 1 and 2 project is being implemented by KNCV TB foundation Nigeria. The project is targeted at increasing the number of tuberculosis (TB) cases that are detected, treated and notified to 437,895 within the five-year grant implementation period 2020 to 2025 across the 14 states in Nigeria.

Training of health workers.

The second wave of the COVID-19 pandemic still disproportionately threatens the poorest and marginalized including persons affected by NTDs and PWDs. The previous rounds of DAHW relief did not reach all persons affected by leprosy/BU in the supported states. This round will target PWDs in the LGAs where the CBID pilot project was conducted, some persons affected by leprosy/BU as well as 3 hospitals which serve as NTD referral centers. Radio phone- in programmes will be organized to create awareness. Cash transfer will be the main mode of distribution in accordance with preference expressed by beneficiaries surveyed.

To ascertain the socio-economic situation of persons affected by leprosy and their family members. To determine the effect of COVID-19 pandemic on the socioeconomic situation of persons affected by leprosy in southern Nigeria. To assess the current level of stigma and discrimination against persons affected by leprosy and their family members. To explore the effect of stigma and discrimination on socioeconomic situation of persons affected by leprosy.

The current project will build on strategies which have proven successful and rewarding. These include reliance on Local Government Area clusters (LGA Clusters) for case- finding and management; Output-based Stipend for case detection of BU, Leprosy & Yaws; collaborating with traditional and faith healers; reconstructive surgeries for eligible patients; educational support for school age children. Increasingly, mobile Health (mHealth)/tele-Health is deployed to facilitate remote diagnosis and care (Skin NTDs) especially for patients living in hard-to-reach communities. In this scheme, frontline health-workers will take pictures of lesions of interest and shared on dedicated group fora on mobile platforms (WhatsApp, Telegram, etc.).

The world is reeling from the devastating effect of the Covid-19 Pandemic which seems to have deflected much needed attention away from other infectious diseases, Leprosy must not be overlooked and there is need to fight leprosy. Accentuate and protect the human right of persons affected whether in the diagnosis, treatment, policies legislation and attitudes of society in general.

The project aims to enhance the social inclusion of PWDs in the 2 local Governments. Capacity of persons with disability (JONAPWDs) and persons affected by leprosy (IDEA) will be strengthened to promote the Disability Act, rights and social inclusion of PWDs in Enugu. The project will also facilitate the formation of association of persons affected by leprosy in the 2 LGAs. Trained PWDs will conduct advocacy visits and appropriate surveys to identify their needs, opportunities and threats to social inclusion. Additionally, selected PWDs will be mentored on grant proposal writing to access funding opportunities for DPOs.

Nigeria ranks 6th among the 14 high TB burden countries globally and has the highest TB burden in Africa (2018 Global TB Report). The TB National Strategic Plan (2015 – 2020) had included a target of 30% of total notifications to be contributed by private providers but only 11% of the TB cases notified in 2017 were from the private sector. The private sector includes nongovernmental organizations (NGOs), faith-based organizations, corporate health services, private hospitals, private chest physicians and general practitioners, community pharmacies, private laboratories patent medicine vendors, and traditional healers, traditional birth attendants, religious houses and other unqualified medical practitioners. The focus of this Program is to scale up TB prevention diagnostic and treatment services through Private sector engagement.

1. Improve early leprosy case detection by 50% and reducing deterioration of disability grading by 50% by the end of 2020 in collaboration with NTBLCP and other partners.
2. Working with NTBLCP and other partners to reduce the burden of Tuberculosis by bridging the Gaps in TB control in Nigeria in selected LGAs by 2020.
3. To provide integrated morbidity management of endemic NTDs in 11 states by 2020
4. Improving Programmatic Management

The triple challenge of declining case detection, persistent late diagnosis and ongoing transmission of Leprosy will be one of the main issues to be addressed in this project. The dearth of skilled health workers for the diagnosis of TB especially childhood TB, funding for contact tracing, management of treatment interruption, consistent power supply for GeneXpert laboratories, continuing need for operational research to enhance policy and practice and inadequate provision of IPT for under 5s are the main gaps in TB control to be addressed. With the exception of Leprosy and Buruli ulcer, there is no established structure for morbidity management of NTDs in the country.

Main focus will be self-care for Morbidity Management and Disability Prevention (MMDP). Activity implementation will be re-organized to run at district or local government area (LGA) level in some selected States. The following strategies will be adopted in the implementation of the project: Output -based approach (OBA), skin camps for integrated case-finding in communities and schools. The direct beneficiaries will be inhabitants of endemic LGAs of the project states. The project will impact positively on the lives of these poor and down- trodden population who have continually fallen victims of neglect in planning and resource allocation by past and present governments.

Support and coordinating the management of DR-TB patients in the community, training of local government DR-TB teams on programmatic management of DR-TB, support for conducting quarterly state DR-TB team meetings as well as coordinating movement of sputum specimens.

1. To provide Nigerians with universal access to high-quality, patient-centered prevention, diagnosis and treatment services for TB, TB/HIV, and avert drug-resistant TB by 2020.
2. To reduce new TB infections, and improve the quality of life for the infected and affected.

Nigeria is among the 10 countries that accounted for 80% of missing TB cases globally (WHO GTB Report 2018). Based on 2012 national TB prevalence survey, it is estimated that 407,000 people in Nigeria have TB each year. Also, there are an estimated 63,000 HIV positive people that get TB each year. An estimated 115,000 HIV negative people die from TB in Nigeria each year and an estimated 39,000 HIV positive people also die from TB. In 2017 only 104,904 TB cases were detected out of an estimated 407,000 of all TB cases expected to be detected in 2017. This figure indicates a treatment coverage of just 25.8%. This leaves a gap of 302,096 cases which were either undetected or detected but the cases were not notified, especially in "non-DOTS sites.

The project seeks to bridge the gap in morbidity management and disability prevention which is due to poor capacity of health workers, non-involvement of patients and families in care as well as knowledge gap in causes and management of NTDs. The objectives of the project include:

2.1. Improve knowledge & skills of health care workers and communities in Ogbaru L.G.A. to identify, provide care and manage NTD complications locally or refer.

2.2. Promote knowledge and skill transfer about self-care from HCW to people with CM-NTDs and their families.

2.3. Increase and Improve practices of Self-care of people affected by NTDs.